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Patients Want Access To Physician Notes Despite Privacy Concerns

Posted on October 4, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

While privacy concerns remain, patients’ desire to access their medical records online seems to outweigh those concerns, according to a study reported in iHealthBeat.

The study, which was published in the Journal of Medical Internet Research, included 3,874 primary care patients at Beth Israel Deaconess Medical Center, Geisinger Health System and Harborview Medical Center. Each of these institutions implemented OpenNotes, a portal which allows patients to read the notes written by their doctors following office visits, e-mail correspondence and phone calls. The patients were able to view the notes via the portals where other parts of their medical records are stored.

Researchers interviewed patients at baseline, prior to their using the OpenNotes portal. They were interviewed again after a one year period during which they were able to use the OpenNotes portal to review the notes doctors made during their visits.

Privacy remained a concern throughout the study period, iHealthBeat noted. At the study’s outset, about 33 percent of OpenNotes project participants reported having concerns about privacy;  meanwhile, almost 37 percent said they were concerned about privacy after the one year period of using the portal.

After using the portal  for a year, 15.5 percent of patients said they were more concerned about privacy, while 12.7 percent said they were less concerned about privacy.

That being said, study participants were still very enthusiastic about having access to the notes. In fact, at the study’s end, 99 percent of participants said they wanted continued access physician notes, despite their initial privacy concerns.

In April of last year, when I first wrote about this project, I  predicted that patients would become very attached to the level of intimacy OpenNotes would offer with their providers.  It seems that this has come to pass. If 99 percent of patients want to continue with the project despite having privacy concerns, that’s a ringing endorsement of the concept. Now, I’m curious as to whether other institutions will get on board.

A Rosa Parks for EMRs

Posted on May 7, 2012 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

From the Healthcare blog, this week there’s a super interesting post on Regina Holliday, a widow turned patient rights advocate.

First some background about Holliday: She’s a widow with young kids, her husband Fred died after weeks of suffering from from cancer. She is now taking her patients’ rights advocacy before the American Heart Association by protesting the lag in how soon patients can see their medical records. Holliday’s personal experiences inform her protest.

From the post:

When [Hollidays] sought access to [Fred’s] electronic medical record, the hospital responded by saying “we must wait 21 days and pay 73 cents per page to see the story of his care. Then they told us we could go home to die.”

Per Meaningful Use Stage 1 guidelines, patient records must be made available within 4 days. Holliday is asking for access within 24 hours. American Hospital Association (AHA) in all its wisdom is asking for 30 day lag.

The one issue I don’t see addressed either by Holliday nor by Michael Millenson in his post is the question of cost. Who will bear the cost of making records available immediately? Will it roll downhill to the patient, or become a shared cost between patient and provider? Still I hope Holliday succeeds, it is a radical idea worth pondering over.